Survey Questionnaire Screenshots

Attachment 11 - Survey Questionnaire Sample Screenshots (9.29.21).pptx

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0920-0910 can be found here:

Document [pptx]

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CDC Emerging Tobacco Products Communication Initiative

OMB Submission – GenIC #0920-0910

Attachment 11: Survey Questionnaire Sample Screenshots

Eligibility Screener

Consent Screens

Questionnaire

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